Blood Filtering May Improve Prognosis After CPR

NEW YORK (Reuters Health) - After resuscitation from cardiac arrest, there's a high risk of the patient dying from intractable shock, but this may be averted in some cases by a blood filtering procedure, according to a small study.

Lack of circulation followed by restoration of blood flow -- ischemia-reperfusion -- is known to cause widespread damage to blood vessels. This is thought to lead to death by multiple organ failure following successful resuscitation, Dr. Mehran Monchi and colleagues note in the Journal of the American College of Cardiology.

Previous research in animals has indicated that high-volume blood filtration removes molecules associated with reperfusion injury and improves outcome.

Theorizing that high-volume hemofiltration could benefit patients who recover spontaneous circulation after cardiac arrest, Monchi, from Institut Jacques Cartier in Massy, France, assigned 61 resuscitated patients to hemofiltration, hemofiltration plus body cooling, or standard treatment.

Survival was significantly better in the hemofiltration group and the hemofiltration plus cooling group compared with standard care. Hospital survival rates were 45 percent, 45 percent, and 26 percent, respectively, and 6 months later the numbers were 45 percent, 32 percent and 21 percent.

While the result "supports our working hypothesis that high-volume hemofiltration may improve overall survival," the research team says, definite conclusions can only be made after larger clinical trials. SOURCE: Journal of the American College of Cardiology, August 2, 2005.